376101497-6-7-2023-51-CC-ALMA-CSKPLK-20230607112452

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101497
Report Date: 06/07/2023
Date Signed: 06/07/2023 11:25:07 AM

Document Has Been Signed on 06/07/2023 11:25 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	GAZARYAN, OGANES FCC		FACILITY NUMBER:	376101497
ADMINISTRATOR:	OGANES GAZARYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 672-4935
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92117
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	06/07/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Oganes Gazaryan		TIME COMPLETED:	11:45 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 6/7/23 at 9:10 AM Licensing Program Analyst (LPA) Adrian Mangina conducted an announced Pre-Licensing inspection with the applicant. Also in the home was sister Gayane Melikyan who provided translation. The three bedroom three bathroom two story home was toured and inspected to ensure an environment safe for the care and supervision of children. A copy of the rental agreement was provided as proof of control of property. Applicant states that they have sufficient financial resources to sustain the license. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Applicant rents the home and has provided the Landlord Notification Form. Applicant completed the preventative health with lead and nutrition on 4/15/23. First Aid and CPR expire on 1/2025. Family Child Care Orientation was completed 2/9/10. Mandated Reporter Training AB 1207 was completed on 1/20/23. Staff immunization requirements per SB792 were met. Applicant has the required immunizations. Applicant states that there are no weapons in the home. Applicant will be using the following rooms for childcare: living room, bedroom and hallway bathroom. The following areas will be off limits: entire second floor, kitchen, dining area, hallway off kitchen, bathroom and bedroom off kitchen hallway, and attached garage. The off-limit areas either have safety latches, locks, doorknob covers, or gates to prevent access. There is a spa located in the accessible back yard that has a properly latched cover that meets requirement and can hold the weight of and adult and is marked with the F-1326-91 symbol. continued on LIC809 page 2

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GAZARYAN, OGANES FCC	FACILITY NUMBER: 376101497
	VISIT DATE: 06/07/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LIC809 page 2

The 2A10BC fire extinguisher, and combination smoke detector and carbon monoxide detector located in living room meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. The applicant has sufficient toys and equipment available. Outdoor play area is the fully fenced backyard.

The new provider packet was reviewed with the applicant including information on ratios and capacity, child abuse reporting, children’s records, immunizations, adults living or working in the home, car seat law, shaken baby syndrome, SIDS, safe sleep practices, effects of lead poisoning, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers, and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided applicant with the following information:
· Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov.
· For common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.

LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

continued on LIC809 page 3

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GAZARYAN, OGANES FCC	FACILITY NUMBER: 376101497
	VISIT DATE: 06/07/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LIC809 page 3

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reviewed with Applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Applicant has obtained landlord consent to care for up to 14 children, including any children living in the home under ten years old.

The following corrections are needed prior to the issuance of the license:
1) Provide proof of pertussis vaccine (TDAP or DTP)
2) Make attached garage inaccessible
3) post required documents

Applicant understands that corrections must be submitted to the Department within 30 days, no later than 7/5/23, or the application may be denied.

Exit interview conducted and report was reviewed with the Applicant, Oganes, Gazaryan .

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3